Clinical Report: The Role of Trained Immunity in Linking Chronic Liver Disease and Periodontitis
Overview
This review explores the concept of trained immunity (TI) as a mechanism linking chronic liver disease and periodontitis through the proposed 'Liver-Gut-Immune-Oral Axis.'
Background
Chronic liver diseases affect over 800 million people globally, while periodontitis impacts 50% of adults. The concept of trained immunity offers a perspective on how innate immune responses can perpetuate inflammation across these systems.
Data Highlights
No numerical data or trial data presented in the article.
Key Findings
['Trained immunity allows innate immune cells to acquire long-term functional memory through metabolic and epigenetic reprogramming.', "The 'Liver-Gut-Immune-Oral Axis' is proposed as a framework connecting chronic liver disease and periodontitis.", 'Liver-gut dysfunction may induce bone marrow training, leading to hyper-reactive monocytes that exacerbate periodontal inflammation.', 'Conversely, periodontal pathogens can reprogram hematopoietic progenitors, accelerating liver disease progression.', 'Both pathways converge on shared metabolic-epigenetic reprogramming circuits.']
Clinical Implications
Understanding the interplay between these conditions can inform precision medicine approaches for inflammatory comorbidities.
Conclusion
The proposed framework of the 'Liver-Gut-Immune-Oral Axis' emphasizes the need for empirical validation of the mechanisms linking chronic liver disease and periodontitis through trained immunity.
Saro Khemichian, MD, is a transplant hepatologist with the USC Transplant Institute, part of Keck Medicine of USC, who cares for patients across the full spectrum of liver diseases, from mild liver conditions to advanced cirrhosis and liver failure, including those who have undergone a liver transplant.
